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Randomised controlled trial
While hormone therapy unlikely harmful in younger postmenopausal women at low CV risk, protective effects cannot be claimed
  1. Beth L Abramson
  1. Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Canada
  1. Correspondence to: Beth L Abramson
    Division of Cardiology, St. Michael's Hospital, University of Toronto, 30 Bond Street Toronto, Ontario, Canada M5W 1B8; abramsonb{at}

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The last 10 years have clarified the issues regarding postmenopausal hormone therapy (HT) and cardiovascular disease (CVD). Prior to the large, randomised women's health initiative (WHI),1 observational studies had suggested a protective cardiovascular (CV) effect. The WHI showed no benefit, and increased thromboembolic and CV events in women taking HT. The WHI findings have been challenged because of the older age of the participants.2 A ‘critical timing’ hypothesis has been suggested to try to explain how the use of HT at the onset of menopause could be cardioprotective, whereas later initiation could cause adverse events.3–,6 …

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